Chlamydophila pneumoniae Infection Assessment in Children with Adenoid Hypertrophy Concomitant with Rhino Sinusitis

Abstract

Background:Since adenoids may act as a reservoir for bacteria, they can cause ear infection, recurrent otitis and recurrent adenotonsillitis. Therefore, adenotonsillectomy is an efficient method for reducing the number and severity of subsequent infections.Objectives:This study aimed to determine the Chlamydophila pneumonia infection by serological tests and performing PCR in the adenoid tissue, in children undergoing adenoid surgery and compare the results with normal children.Patients and Methods:This case control study was conducted in the ENT and pediatric wards of Rasoul Akram Hospital in Tehran (2008-2011). We studied 53 patients who had undergone the adenoid surgery (adenoid hypertrophy concomitant with rhino sinusitis) and 31 other patients undergoing elective surgeries in the general surgery ward (like orthopedic surgeries, hernia, etc.) without any infection (like rhinosinusitis), as the control groups. We searched for C. pneumoniae by PCR kits (Chemicon, Germany) in resected adenoid tissues and nasopharyngeal swabs of controls (ethics restrictions in controls). We also looked for specific IgM & IgG antibodies (ELISA, Biochem Immuno Systems, Italy) and compared them between the two groups. A P value < 0.05 was considered statistically significant.Results:Positive PCR results were observed in 13.5% of cases and none of the controls. The condition prevalence was higher in warm seasons (P = 0.05). No correlation was found between positive PCR results and patients' gender. IgM presence was observed in 11% (6.51) of cases and 6.5% (2.31) of controls (P = 0.7). IgG results were not positive in any of the cases (0.51), whereas positive results were seen in 13.3% of the controls (P = 0.007). IgM results showed no significant difference with PCR results (P = 0.7) but IgG results did (P = 0.05).Conclusions:The results of the study showed a positive correlation between PCR and serology (IgM) results in the case group. Recent C. pneumoniae infection was proved to exist by PCR and serology (IgM) in patients who had undergone adenoidectomy. In contrast to the controls, none of the patients in the study group showed previous immunity. Findings indicate the probable role of C. pneumoniae infection, in inducing adenoid hypertrophy in nearly 13% of cases.

Frequency of Mycoplasma pneumoniae, Legionella pneumophila and Chlamydia spp. among patients with atypical pneumonia in Tehran

“…Javadi Nia et al. [ 33 ] determined the prevalence of C. pneumoniae in children with adenoid hypertrophy concomitant with rhinosinusitis. In their study the pathogen was detected in 13.5% of patients using PCR, but their target group is completely different from ours.…”

Adenoidal Disease and Chronic Rhinosinusitis in Children—Is There a Link?

“…The indication to perform at first a simple adenoidectomy (tonsillectomy is not indicated) is due to the strong relationship that exists between AH and CRS. Some authors prefer to speak of relationship between CRS and adenoiditis [18,19,20] rather than between AH and CRS, but most prefer the latter, in consideration of the etiology of AH as a likely consequence of chronic adenoiditis [17,21,22,23]. Over the past few years, several authors demonstrated the correlation between AH and CRS through different types of studies, based on the endoscopic study of the adenoid volume [24] on the same bacterial strains both on the adenoidal tissue and in the nasal sinuses [20,22,23,25,26,27,28] on the positive effects on CRS by adenoidectomy [21,29,30,31] on specific immunologic modifications [32,33,34] and on radiological findings [35].…”

“…Several research groups over the last 10 years focused on the identification of other bacterial strains that could shed new light on CRS etiology and on the relationship between AH and CRS. An interesting study by Nia and colleagues focused on Clamydophila pneumoniae , this uncommon infection can lead to CRS in the pediatric population, particularly in middle east countries [22]. The group demonstrated that adenoids can act as a reservoir for Clamydophila pneumoniae , and cause rhinosinusitis concomitant with AH.…”

Etiologies and Treatments of Odontogenic Maxillary Sinusitis: A Systematic Review

“…The predominant anaerobic flora was peptostreptococcus in all studies, while the anaerobic Gram- negative bacilli were the second most common factor in most studies ( 23 - 25 ). Furthermore, other studies showed that the most common causes of rhinosinusitis were Staphylococcus aureus and Pneumococcus ( 36 , 37 ). These findings suggest that the flora implicated in odontogenic sinusitis are very similar to the flora in the oral cavity.…”